Journal Mobile

AJ Fyfe, P McKay
Journal Issue: 
Volume 40: Issue 3: 2010




Bleomycin  is  an  anti-neoplastic  antibiotic  used  in  chemotherapeutic regimens for Hodgkin lymphoma, testicular tumour and Kaposi’s sarcoma and to induce chemical pleurodesis in malignant effusions. Bleomycin toxicity predominantly affects the skin and lungs. Skin toxicity classically presents as flagellate erythema, a rare  drug  rash,  where  the  patient  appears  to  have  been  whipped.  Bleomycin-induced  pneumonitis  is  more  commonly  recognised  and  can  occasionally  prove fatal. Although  both  these  conditions  are  well  documented  in  the  literature,  in clinical practice they are uncommon. Indeed, in our institution (a teaching hospital with  a  large  lymphoma  practice)  we  cannot  recall  a  previous  case  of  flagellate erythema.  Both  skin  and  lung  toxicities  induced  by  bleomycin  usually  respond  to discontinuation  of  the  drug  and  steroid  therapy. We  present  two  case  studies  of patients with bleomycin-related toxicity and a short synopsis of current literature.